UPDATE: This was originally posted on January 4, 2013. Illinois Health Connect (IHC) would like providers to know that, as of February 25, HFS has not provided any further information about this rate increase or what the process for attestation may be. IHC will keep providers updated as new information becomes available.
To answer questions from the provider community about the Affordable Care Act requiring a provider rate increase, the Illinois Department of Healthcare and Family Services (HFS) provided the statement below. Illinois Health Connect encourages all providers to sign up to receive email notification of HFS Provider Releases. HFS will issue a Provider Release that informs providers of all the relevant details regarding the Affordable Care Act rate increase.
"Effective January 1, 2013, HFS is required to reimburse providers at Medicare rates for certain codes as defined in the Affordable Care Act. The Department is currently working on the programming necessary to implement these rate changes. If the programming is not in place until after January 1, 2013, the rate changes, when implemented, will be retroactive to the effective date."
The Agency for Healthcare Research and Quality (AHRQ) has developed a Children's EHR format that more optimally supports the care of children. This format provides information to EHR developers and others that need to be present in an EHR system to address the healthcare needs specific to children, especially those enrolled in Medicaid.
The Children's EHR Format is accessible and adoptable for use during product development and enhancement. Pediatric providers can use the Children's EHR Format when evaluating which EHR system to purchase.
The child-specific data and functionality recommendations are sorted into various topics, including: prenatal and newborn screening tests, immunizations, growth data, information for children with special healthcare needs and well-child preventive care.
Chicago Department of Public Health (CDPH) Fast-Track immunization clinics provide free vaccines to children ages 0-18 years old.
No appointment is necessary. Vaccines are given on a first come, first served basis. The clinics also offer flu shots for adults of all ages.
Roseland Community WIC: 11255 S. Michigan Avenue, 773-785-1173. Hours of operation: 8 a.m. to 3:30 p.m. on Mondays, Tuesdays, Wednesdays.
Great Lawn WIC: 4150 W. 55th Street, 312-747-5416. Hours of operation: 8:30 a.m. to 3:30 p.m. on Mondays, Tuesdays, Wednesdays.
Uptown Neighborhood Health Center: 845 W. Wilson, 312-742-3227. Hours of operations: 8 a.m. to 4 p.m. on Mondays and Fridays, 10 a.m. to 6 p.m. on Thursdays.
Lower West WIC: 1643 W. Cermak, 312-747-1650. Hours of operations: 8:30 a.m. to 3:30 p.m. on Thursdays and Fridays.
Englewood Neighborhood Health Center: 641 W. 63rd Street, 312-745-1000. Hours of operation: 10 a.m. to 6 p.m. on Thursdays.
HFS has posted a frequently asked questions (FAQ) document for the Illinois Medicaid Redetermination Project. The document explains what redetermination is, and how to respond to letters you may get.
At least once each year, the state must make sure that you are still eligible for benefits. Redetermination is the annual process of reviewing your case.
You will be sent your new HFS medical card after your annual redetermination.
You will be contacted if the state needs you to send more information. It is important to provide this information. Not responding could result in losing benefits. This information could include proof of income, address, Social Security number, other insurance and how many people live with you.
HFS also posted samples of the letters you may receive about redetermination.
The Illinois Department of Healthcare and Family Services (HFS) sent out a blast email on February 15 informing providers that the February mailing of the HFS medical cards will be the final time medical cards are sent on a monthly basis. HFS will send the new annual medical cards in the next few weeks.
HFS also announced that the February mailing has been delayed and apologized for this inconvenience.
Providers should not refuse service to HFS clients due to not having a February card. Clients should not be encouraged to contact their DHS office to get a temporary card.
The client's recipient identification number does not change and can be used to determine eligibility or PCP status. If the client's medical card number is not available, it is possible to verify client eligibility and PCP assignment using the HFS MEDI System using a client's name and either their date of birth or their Social Security number.
The Illinois Health Connect Provider Services Help Desk can verify PCP status, but cannot verify client eligibility. Call 1-877-912-1999, extension 3. The IHC Provider Services Help Desk is open Monday-Friday from 8 a.m. to 7 p.m.
The Automated Voice Response System (1-800-842-1461) can verify client eligibility as long as the client's medical card number is available.
The Illinois Department of Healthcare and Family Services (HFS) has issued a brochure that explains the new HFS medical card. The brochure and a sample of the new card are available on the HFS website.
It is important to take the new medical card and picture ID to each appointment.
Cards will not be sent every month. Do not throw away the new medical card. Even if your benefits end, keep the card. You can use it again if you get benefits in the future.
If you forget your medical card, you can still receive healthcare services. Give your provider your name, and either your social security number or your date of birth. Always bring your picture ID.
If your medical card is lost or stolen, you can request a replacement. There is no charge for a replacement card. Call DHS at 1-800-843-6154 or HFS at 1-800-226-0768 (TTY 1-877-204-1012). The replacement card will be mailed to you.
The Illinois Department of Healthcare and Family Services (HFS) has continued its implementation of the Four Prescription Policy, announcing that, effective February 4, HFS clients will need Prior Approval (PA) if they fill more than five prescriptions in a 30-day period.
Prescribers are strongly encouraged to submit PA requests using the HFS MEDI System. Entering PA requests via MEDI results in a more efficient review process as it does not require HFS to do data entry. PA requests are typically reviewed within two hours if entered via MEDI, but can sometimes take longer. If a PA request is sent using MEDI application, prescribers can check the status using the confirmation number provided in MEDI.
PA requests can also be submitted using the online form on the HFS Four Prescription Policy page. The HFS Pharmacy phone and fax number, along with the fax form and the online form to check the status of a non-MEDI request, are also available on the Four Prescription Policy Page.
Prescribers are strongly discouraged to send PA requests via phone and should not call the HFS Pharmacy number to check the status of a PA request.
Medications exempt from the policy include antibiotics, contraceptives, oncology agents, immunosuppressives, anti-retroviral agents, over-the-counter drugs and non-drug items such as blood glucose test strips and monitors.
At this time, this policy does not apply to clients less than 19 years old.
